Work

Diagnosis and management of juvenile axial spondyloarthritis: Lessons and links to adult disease

Year: 2026

Type: article

Abstract: classify JIA into seven mutually exclusive categories (2, 3).Most juvenile spondyloarthritis (JSpA) presentations are captured within the Enthesitis-Related Arthritis (ERA) or Juvenile Psoriatic Arthritis (JPsA) categories, which parallel peripheral and non-radiographic spondyloarthritis (SpA) in adults, respectively (3).Approximately 20% of SpA cases have onset before age 18 years, about 20% of children with JIA have JSpA, and about 20% of JSpA patients develop axial disease (axSpA).Axial disease confers substantial morbidity in both pediatric and adult populations (4).This review summarizes the key points from the ACR presentation, briefly elaborates where useful, and cites relevant literature to contextualize diagnostic and management considerations for axJSpA. Key Features of Axial Disease in Juvenile Spondyloarthritis (AxJSpA)Compared with adults, children with axJSpA more commonly have concurrent peripheral disease consisting of arthritis and/or enthesitis.Symptoms attributable to axial arthritis are often insidious, worse with rest and improved by movement, while enthesitis pain typically worsens with activity.Extra-articular manifestations, including acute symptomatic anterior uveitis, gut inflammation, and psoriasis, can also occur.About 50% of children with JSpA are Human Leukocyte Antigen (HLA)-B27 positive, a lower proportion than in adults (5).

Source: touchREVIEWS in RMD

DOI: 10.17925/rmd.2026.5.2.3

Authors: Dax Rumsey, Pamela Weiss

Institutions: University of Alberta, University of Pennsylvania

Language: English

Topic: Spondyloarthritis Studies and Treatments

Subfield: Rheumatology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: bronze

Funders: Pfizer, Spondylitis Association of America, National Institutes of Health, National Institute of Arthritis and Musculoskeletal and Skin Diseases